Discrimination by the government as it responded to the pandemic, and within the NHS, could be to blame for disabled people’s sharply-increased risk of dying from COVID-19, according to researchers backed by the Office for National Statistics (ONS).
A new study, partly carried out by ONS and based on analysis of 29 million adults in England during the pandemic, says that working-age disabled women with higher support needs have been about 90 per cent more likely to die from coronavirus than non-disabled women of the same age, even after taking factors such as underlying health conditions, poverty and whether they lived in a care home into account.
The study says that the increased risk to disabled people from coronavirus is caused by “a combination of disadvantageous circumstances”.
And it calls for urgent “protective measures”, such as ensuring younger disabled people are prioritised for vaccination.
The study is the latest to find that 58 per cent of those who died from COVID-19 in England were disabled people.
In all, between 24 January 2020 and 28 February 2021, 105,213 people died from causes involving COVID-19 in England, says the study, and about 61,000 of them were disabled people.
The increased risk of death faced by older people and those with underlying health conditions has been widely reported during the pandemic, but almost no attention has been paid to the discrimination that appears to have led to disabled people dying in disproportionate numbers from COVID-19.
The study, carried out by ONS and researchers at London School of Hygiene and Tropical Medicine (LSHTM), concludes: “Disabled people in England had markedly increased risk of mortality involving COVID-19 compared to non-disabled people and should be prioritised within the pandemic response.”
As well as vaccination, it says there should be a focus on disabled people’s needs within activities such as the provision of accessible health information, testing, shielding, and protection in care homes.
The study says that among people aged between 30 and 69, women seen as “more-disabled”* were more than eight times more likely to have died from COVID-19 than non-disabled women in the same age group, while more-disabled men between 30 and 69 were more than five times more likely to die than non-disabled men.
But the ONS/LSHTM article, which has not yet been peer-reviewed, also says that after allowing for factors such as people’s underlying health conditions, and whether they lived in poverty, in a less affluent part of the country or in a care home, disabled people were still significantly more likely to have died from coronavirus.
It shows that, once these factors have been allowed for, more-disabled women between 30 and 69 were 91 per cent more likely to have died from COVID-19 than non-disabled women in the same age group.
More-disabled men in the same age group were 74 per cent more likely to have died from COVID-19 than non-disabled men in the same age bracket.
These figures are higher than those previously produced by ONS (60 per cent for more-disabled women and 37 per cent for more-disabled men) in a statistical release in February, while the researchers even suggest that their figures are likely to under-estimate the link between disability and COVID-19 deaths
The study examines deaths that took place between 24 January 2020 and the end of February 2021, and so covers much of the second wave of the pandemic.
The researchers also say that disabled people were at excess risk for all causes of death during the pandemic, with only about 22 per cent of their deaths involving COVID-19.
The researchers said this finding suggests a need to improve services and access to healthcare for disabled people and to address the “drivers of disadvantage and excess mortality” they face, both during and after the pandemic.
The LSHTM researchers who were part of the study told Disability News Service (DNS) that there were “many possible reasons” for disabled people’s increased risk of death from COVID-19, “including discrimination within the health service, in the government’s response, or within the community”.
They said: “Such discrimination might have increased the risk of acquiring COVID-19 and reduced the chances of recovery.
“However, we do not have data on these factors and therefore can only speculate.”
They stressed that discrimination could also have been responsible for some of the increased risk caused by some of the factors they did take account of in their calculations, as “discrimination could lead to a disabled person living in a less-well-off area, living on a reduced income, and being susceptible to [pre-existing health conditions]”.
The LSHTM team called for more consideration to be given to preventing disabled people becoming infected with coronavirus, for example by prioritising them for vaccines, or providing accessible information; and for better access to treatment, such as providing outreach services for people who face transport barriers.
They also suggested an improvement in the “effectiveness of the treatment” for disabled people, for example through training healthcare workers how to treat disabled people “effectively and with high quality”.
And they called for more data collection and research to understand more about the association between disability and deaths during the pandemic, and to identify groups that are at particularly high risk, including people with learning difficulties.
ONS said there were “several possible explanations for the residual elevated risk in disabled people”, but it confirmed its previous statement that unfair practices or discrimination within the NHS may have been one of the causes and that this evidence “warrants further investigation”.
But an ONS spokesperson said that it could not “say with certainty whether it is or isn’t a factor, because we don’t have data on it”.
Throughout the pandemic, disabled campaigners have repeatedly raised the alarm about discriminatory treatment by the government in its response to the crisis, with DNS collating at least 24 examples of breaches of their rights in the year since the first lockdown.
The LSHTM researchers told DNS this week that discrimination by the government in its pandemic response could be a cause of some of the increased risk of death from COVID-19 faced by disabled people, although they stressed that this was only “speculation” at this stage.
Disabled campaigners have also raised concerns about discriminatory treatment within the health system that they say has put their lives at risk during the pandemic.
This has included discriminatory guidance issued by health bodies on who should receive priority for intensive care treatment during the pandemic; an NHS trust telling people with muscular dystrophy it was keeping their ventilator filters for COVID patients; GPs writing to disabled patients to ask them to agree to sign “do not attempt cardiopulmonary resuscitation” orders; the failure to provide shielding information in an accessible format; and discriminatory NHS England guidance on hospital visitors.
The LSHTM researchers said that discrimination within the NHS was a possible explanation for some of the increased risk of death faced by disabled people during the pandemic.
*The study examines the impact of the pandemic on those who had described themselves as disabled people in the 2011 census, either by saying they were “limited a little” (less-disabled) in their daily lives or “limited a lot” (more-disabled)
**For sources of information and support during the coronavirus crisis, visit the DNS advice and information page
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